The Ultimate Guiding Principles
The fundamental tenets of life and human existence are based on some guiding principles such as social responsibility. It is patently obvious that physicians have ethical obligations as good stewards of limited resources.
Should cost considerations be included in medical decisions?
When meeting with medical needs of patients under their care, cost can be taken into consideration when there are options for the best way to treat a patient. Stewardship flows from physicians’ obligation to do what is best for the patient’s health, whatever the price tag.
Yet there are factors away from the bedside, outside of doctors’ control, that impede their ability to be good stewards. Serving as good stewards of resources by controlling costs, improving efficiency, and reducing waste are also part of social responsibility.
However, there might be options available as the physician uses his or her knowledge of the efficacy of treatments, tests and procedures, and their costs — both short-term and long-term.
Engaging patients and their families in health care delivery
Even a treatment that is more expensive up-front could save money and improve a patient’s health over time. Physicians can involve patients and their families in the decision- making, laying out the case for a less expensive treatment that would be just as effective as one that costs more.
Doctors already are under ethical obligation to avoid performing unnecessary tests and procedures, even if a patient demands them. Ultimately, it is transparency and clear communication between the physician and patient (and the patient’s family) that provides the best environment for a doctor to make the right treatment decision and wisest move as a steward of health care resources.
Social Responsibility of Physicians in a Changing Health Care System
Physicians also face ethical dilemma on how to be socially responsible and keep profit margin high enough to stay in business. Ethical practice in this case involves making well-informed choices about strategic planning, availability and provision of services.
When profit is used appropriately it can have a positive impact on one’s ability to be socially responsible but there are reservations about the policy due to limited resources. This is a serious economic concern since it is not always obvious which medical alternative offered is less expensive. An intervention that may be less expensive in the short term could be costlier in the long run.
Ethics and Values in Clinical Practice: Whom Do They Help?
Physicians can consider this ethical policy of costs in care choice more than an obligation but consequences of actions and their effect on others. Consequently, they can weigh the consequences and their discretions to be wise stewards of resources in making decisions based on the good that they can achieve.
Rule by utility helps guide decisions so that, on average, it produces the greatest good for the greatest number or cause the least amount of harm to the least amount of people.